老年高血压患者左心室肥厚与动态血压参数和炎症标志物的相关性

Correlation of ambulatory blood pressure monitoring parameters and inflammatory biomarker levels with left ventricular hypotrophy in elderly hypertensive patients

目的：探讨老年高血压患者合并左心室肥厚（LVH）与动态血压（ABPM）参数和常见的心血管炎性因子水平的相关性。方法筛选2012年1月至2013年12月于解放军总医院干部诊疗科门诊就诊的患者，纳入符合入选标准的初次诊断为高血压的患者152例，其中单纯高血压109例，合并LVH 43例。全部患者接受ABPM检查，测定血清高敏C反应蛋白（ hs-CRP）和同型半胱氨酸（ Hcy）水平。分析ABPM参数与hs-CRP和Hcy水平的相关性。结果老年高血压合并LVH组24h平均收缩压（24hSBP）、夜间平均收缩压（nSBP）和夜间平均脉压（nPP）均显著高于单纯老年高血压患者（P＜0.05，P＜0.01）；同时，合并LVH患者中血清hs-CRP水平显著高于单纯高血压患者（ P＜0.05），而血清Hcy在两组患者间差异无统计学意义（ P＞0.05）。logistic回归分析显示， nSBP和hs-CRP水平与高血压患者合并LVH相关。结论老年高血压患者nSBP增高和hs-CRP水平升高与合并LV H风险增高相关。

ObjectiveTo investigate the correlation of left ventricular hypothrophy （LVH） with parameters of ambulatory blood pressure monitoring （ABPM） and the levels of established inflammatory biomarkers in the elderly with hypertension.Methods Totally 152 elderly patients with newly-diagnosed hypertension who were screened from the consecutive patients in Out-patient Department of Chinese PLA General Hospital from January 2012 to December 2013 were enrolled in this study. There were 43 patients combined with LVH and 109 without. ABPM was performed in all subjects. Blood levels of high sensitivity C-reactive protein （hs-CRP） and homocysteine （Hcy） were measured. The correlation of the parameters and the levels with LVH was analyzed.Results In the ABPM parameters, the 24 hours mean systolic blood pressure （24hSBP）, nighttime mean systolic blood pressure （nSBP） and nighttime mean pulse pressure （nPP） were significantly higher in the patients with LVH than in those without （P〈0.05,P〈0.01）. The serum level of hs-CRP was also obviously higher in those with LVH （P〈0.05）, but no such difference was found in the level of Hcy between the 2 groups （P〉0.05）. Logistic regression analysis showed that nSBP and hs-CRP level were correlated with LVH in the hypertensive patients.Conclusion Elevated nSBP and higher hs-CRP level increase the risk of LVH in the elderly hypertensive patients.